PIPC Letter to MedPAC: Don’t Rely on Cost-Effectiveness to Make Coverage and Reimbursement Decisions
In a letter to the Medicare Payment Advisory Commission (MedPAC), Over 40 organizations representing patients, people with disabilities, and providers joined PIPC to express concerns about MedPAC’s consideration of cost effectiveness in Medicare. “We are concerned that the “incremental approach” suggested by commissioners may be intended to impose cost effectiveness over time, thereby avoiding intense scrutiny despite its methodological flaws and long-term impact on access to care. Additionally, such a policy recommendation would rely on overturning or undermining the law passed in 2010 by Congress banning Medicare from incorporating the QALY metric used in cost effectiveness analyses.
The letter in its entirety can be found below.